CSF BIOCHEMISTRIES, GLUCOSE-METABOLISM, AND DIURNAL ACTIVITY RHYTHMS IN ALCOHOLIC, VIOLENT OFFENDERS, FIRE SETTERS, AND HEALTHY-VOLUNTEERS

Background: There is an extensive literature describing a central sero tonin deficit in alcoholic, impulsive, violent offenders and fire sett ers. In the present study, we investigated biochemical concomitants of impulsivity and aggressiveness, and the physiological consequences of reduced central serotonin turnover. Methods: Forty-three impulsive an d 15 nonimpulsive alcoholic offenders and 21 healthy volunteers were s tudied in the forensic psychiatry ward of a university psychiatric dep artment. The subjects underwent lumbar punctures and oral glucose and aspartame challenges, and their diurnal activity rhythm was measured w ith physical activity monitors. Discriminant function analyses were us ed to investigate psychophysiological and biochemical concomitants of aggressive and impulsive behaviors. Results: Alcoholic, impulsive offe nders with antisocial personality disorder had low mean cerebrospinal fluid (CSF) 5-hydroxyindoleacetic acid (5-HIAA) and corticotropin leve ls and high mean CSF testosterone concentrations. Compared with health y volunteers, they showed increased physical activity during the dayti me. Alcoholic, impulsive offenders with intermittent explosive disorde r had a low mean CSF 5-HIAA concentration and blood glucose nadir afte r an oral glucose challenge, and desynchronized diurnal activity rhyth m. Healthy volunteers had mean CSF 5-HIAA concentrations that were int ermediate between those of alcoholic, impulsive and non-impulsive offe nders. Alcoholic, nonimpulsive offenders had a significantly higher me an CSF S-HIAA concentration than all the other groups, including healt hy volunteers. Conclusions: In the present sample, a low CSF 5-HIAA co ncentration was primarily associated with impulsivity and high CSF tes tosterone concentration, with aggressiveness or interpersonal violence .